While the teachings of the present invention are applicable to the provision of a windowed dressing for simple wounds, incisions or the like, as will be described hereinafter, they are particularly applicable to a securement dressing for an intravenous infusion needle or catheter and its tubing.
Intravenous feeding and transfusions are among the most frequently performed treatments in hospitals. Infusion apparatus employed in the intravenous feeding of blood, plasma, glucose water, salt water and the like comprises an infusion needle or catheter, a handle portion and a length of tubing connecting the needle to a source of intravenous fluid. Heretofore, the needle or catheter was inserted into the vein of the patient and constrained in position by small strips of adhesive tape attached to the handle portion of the infusion needle or catheter and to the skin of the patient so that the infusion needle or catheter could not be inadverently dislodged. The puncture site of the needle or catheter was often protected with an antibacterial ointment and/or a gauze pad for the purpose of helping to lower the chance of infection. The gauze pad also served as a cushion if placed under the catheter and handle portion. The tubing, as well, was commonly secured to the skin of the patient with several strips of adhesive tape with a portion of the tubing coiled to form a loop and held in place by several additional strips of adhesive tape. The purpose of the coil or loop of the tubing was to absorb any unexpected tension placed on the tubing without disturbing the infusion needle or catheter.
More recently, prior art workers have developed devices intended to simplify and facilitate this rather complex cumbersome and time consuming procedure. Exemplary devices of this type are taught, for example, in U.S. Pat. Nos. 3,046,983; 3,136,158; 3,568,679; 3,782,378; 3,826,254; 3,834,380; 3,885,560; 3,918,446; 3,973,565; 4,059,105; 4,129,128 and U.S. Pat. Des. No. 243,715.
These prior art devices are, in general , characterized by one or more of the following deficiencies. Many of them are difficult to apply, and require removal of the protective layer or liners from their adhesive surfaces prior to placement about the puncture site. Many of them expose the puncture site directly to an adhesive surface. A number of them have no means for visual inspection of the puncture site, and sufficiently cover the area to hide evidence of phlebitis. Frequently, no absorbent means is provided to absorb blood at the puncture site or to absorb medicament for application to the puncture site. A number of the devices have no means for forming a safety loop in the tubing. Many do not provide cushioning of the infusion needle or catheter from the skin. Finally, it is a common requirement that the device be removed in order to change the tubing, inspect the puncture site, or to remove the infusion needle or catheter.
That embodiment of the present invention, comprising a securement device for an intravenous catheter and its tubing, is characterized by a very simple construction permitting easy placement, adjustment, and removal of the liners from the adhesive surfaces after placement about the puncture site. The device may be provided with a non-stick gauze pad which acts as a soft, absorbent cushion for the catheter or infusion needle. The gauze pad absorbs excess blood from the puncture site and the device does not subject the puncture site to adhesive. The gauze pad covers and surrounds the puncture site so that the device can be used as a pressure dressing after conclusion of the I.V. therapy to absorb blood after removal of the catheter or infusion needle. Furthermore, the gauze pad can absorb and retain medicaments at the puncture site.
The base portion of the dressing of the present invention has a longitudinal slit terminating in a flap-forming portion. This, in turn, is surmounted by a reclosable cover strip. This formation creates a flap in the base portion and gauze pad which lifts with the cover strip for direct visualization of the puncture site and/or application thereto of medicaments or the like. The slit also permits adjustment of the dressing so that the cover strip may or may not cover the catheter-tubing joint, as desired. The cover strip may also be used to anchor and retain a safety loop in the tubing. This safety loop can be arranged in one of two positions, a first position being such that the tubing can be changed without disturbing the puncture site, and the other position being such that the puncture site can be viewed without disturbing the tubing.
The dimensions of the dressing device are such that it can be located on the patient's hand without circumferentially wrapping thereabout, thus eliminating any possibility of a tourniquet effect. It is also sufficiently narrow that it will not cover evidence of phlebitis. Finally, the relatively thin gauze pad which is partially located beneath the infusion needle or catheter, allows the infusion needle or catheter to remain relatively parallel to the skin surface while serving as a cushion for it.
As indicated above, the teachings of the present invention are also applicable to a simple windowed dressing for a wound, incision or the like. Prior art workers have provided bandage devices having an access flap. Such a structure is taught, for example, in U.S. Pat. No. 1,610,089. The bandage structure, however, is of the wrap-around type and is not provided with a cover strip which lifts the access flap. Prior art workers have also devised bandage structures which are transparent so as to afford a view of the wound. Such structures are taught, for example, in U.S. Pat. Nos. 2,273,873 and 3,425,412.